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Placenta Accreta Spectrum Disorders: A. Chohan Continuous Squeezing Suture (ACCSS) for Controlling Haemorrhage from the Lower Uterine Segment at Caesarean Section

Author(s)
M. Arshad Chohan Lady Willingdon Hospital / King Edward Medical University,Lahore, Pakistan.
Fauzia Butt Sharif Medical & Dental College,Sharif Medical City Hospital, Lahore, Pakistan.
Maria Imran Lady Willingdon Hospital / King Edward Medical University,Lahore, Pakistan.
Sadaf Zahra Lady Willingdon Hospital / King Edward Medical University,Lahore, Pakistan.
Moiz Arshad Chohan Department of Obstetrics & Gynaecology Lady Willingdon Hospital / King Edward Medical University,Lahore, Pakistan.
Abstract
Objectives: To describe the simplicity, efficacy and safety of A. Chohan Continuous Squeezing Suture (ACCSS) for controlling haemorrhage from the lower uterine segment at caesarean section for placenta praevia and accreta spectrum disorders. Methods: This prospective study was conducted on 47 patients with placenta praevia and accreta spectrum disorders from February 2019 to May 2022 in two teaching hospitals of Lahore and ACCSS was applied. The outcome measures were peripartum hysterectomy procedure time, estimated blood loss, number of blood transfusions, duration of stay in the hospital, bladder trauma, uterine necrosis, pelvic abscess formation, secondary postpartum haemorrhage and maternal mortality. Descriptive statistics were calculated by using SPSS version 21. Results: Out of 47 patients, 7 (15%) had placenta creta, 29 (61.7%) increta, 11 (23.3%) percreta (grade 3a), and 36 (76.6%) centralanteriordominantplacenta.Peripartumhysterectomywaspreventedin97.8%ofpatients.ACCSSproceduretimewas 5-10 minutes (87.2%), with mean blood loss 2500±485 ml, mean blood transfusion 1.85±1.02 units and mean hospital stay of 3.3±0.84 days. One patient had bladder trauma. There was no case of uterine necrosis, pelvic abscess formation, secondary postpartum haemorrhage or maternal mortality. Conclusion: ACCSS appears to be a simple, effective and safe treatment option for placenta praevia and accreta spectrum disorders, as an alternative to hysterectomy.
Publication Details
Page(s) 166-171
DOI DOI not available
Published Journal: Pakistan Journal of Medical Sciences, Volume: 39, Issue: 1, Year: 2023

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Keywords
Peripartum hysterectomy, Postpartum haemorrhage, Placenta praevia, Accreta spectrum disorders
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